Prior Authorization Request definition

Prior Authorization Request means a request for pre-approval from an insurer for a specified prescription or quantity of a prescription before the prescription is dispensed.
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Prior Authorization Request means a Service Authorization Request by the Enrollee, or a provider on the Enrollee’s behalf, for coverage of a new service, whether for a new authorization period or within an existing authorization period, before such service is provided to the Enrollee.
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Prior Authorization Request means a method by which practitioners seek approval from Contractor to render medical services. The Contractor's Utilization Review (UR) Coordinator is responsible for granting approval to providing specific, non-emergency medical services in advance of rendering such services.
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Examples of Prior Authorization Request in a sentence

  • A completed CRCP Prior Authorization Request Form requesting these services must be signed and dated by the treating physician familiar with the client before requesting prior authorization.

  • A copy of the completed, signed, and dated CRCP Prior Authorization Request Form must be maintained by the provider in the client’s medical record.

  • Topic #2482 Place of Service CodesProviders are required to use POS (place of service) codes on the PA/RF (Prior Authorization Request Form, F-11018 (05/2013)).

  • The Prior Authorization Request (PAR)contains the Long Term Care Certification span.

  • Acceptable codes are:E1 = Eligibility Verification with no claim submitted B1 = Rx BillingP1 = P.A. Request and BillingP4 = Prior Authorization Request OnlyB2 = Rx Reversal B2 is used to cancel a previous transaction.

  • Border-state providers of services (those providers located in Arkansas, Illinois, Iowa, Kansas, Kentucky, Nebraska, Oklahoma and Tennessee) are considered as being on the same MO HealthNet participation basis as providers of services located within the State of Missouri.A Prior Authorization Request form is not required for out-of-state nonemergency services.

  • Response Prior Authorization Segment‌This segment will only be sent when a P4 Prior Authorization Request is submitted.

  • Border-state providers of services (those providers located in Arkansas, Illinois, Iowa, Kansas, Kentucky, Nebraska, Oklahoma and Tennessee) are considered as being on the same Medicaid participation basis as providers of services located within the State of Missouri.A Prior Authorization Request form is not required for out-of-state nonemergency services.

  • Section 3.1: My Insurance Manager‌My Insurance Manager is an online tool providers can use to access: Benefits and Eligibility, Claims Entry, Prior Authorization Request and Status, Claims Status, Remittance Information, Your Mailbox, and EDI Reports.

  • The Department staff compare information submitted by the CMA to BUS documentation and Prior Authorization Request (PAR) submissions, client signature pages including but not limited to: intake, service planning, release of information or HIPAA, and the Professional Medical Information Page (PMIP).

Related to Prior Authorization Request

  • Service Authorization Request means a Provider’s or Enrollee’s request to the Contractor for the provision of a service.

  • Prior authorization means that we must approve the Services in advance in order for the Services to be covered.

  • Transaction Request means a request from Seller to Buyer, in the form attached as Exhibit A hereto, to enter into a Transaction.

  • Information Request means a request for any Information under the FOI Legislation.

  • Registration Request has the meaning set forth in Section 2.01(a).

  • Utilisation Request means a notice substantially in the form set out in Schedule 3 (Utilisation Request).

  • Interconnection Request means a Generation Interconnection Request, a Transmission Interconnection Request and/or an IDR Transfer Agreement.

  • Mediation Request shall have the meaning set forth in Section 7.2.

  • Credit Event Resolution Request Date means, with respect to a notice to ISDA requesting that a Credit Derivatives Determinations Committee be convened to resolve:

  • Certification Requirements means those requirements specified or referenced in this Agreement that you must meet in order to use and maintain the Certification Designation and use the Logo in accordance with the terms of this Agreement.

  • Sell Authorization means that Distributor needs to meet specific training and qualification requirements for each product included in an “On Premise” Product Family that Distributor wants to resell as set out in detail in the Distributor Program Guide and the applicable RSPI.

  • Acceleration Request means a request pursuant to Operating Agreement, Schedule 1, section 1.9.4A, and the parallel provisions of Tariff, Attachment K-Appendix, section 1.9.4A, to accelerate or reschedule a transmission outage scheduled pursuant to Operating Agreement, Schedule 1, section 1.9.2 or Operating Agreement, Schedule 1, section 1.9.4, and the parallel provisions of Tariff, Attachment K-Appendix, section 1.9.2 or Tariff, Attachment K-Appendix, section 1.9.4.

  • Extension Request means any Term Loan Extension Request or a Revolver Extension Request, as the case may be.

  • Corporation Request or "Corporation Order" shall mean a written request or order signed in the name of the Corporation by an Officer and delivered to the Debenture Trustee.

  • Authorization Letter means a letter agreement executed by Borrower in the form of EXHIBIT A.

  • Marketing Authorization Application or “MAA” means an application for Regulatory Approval (but excluding Pricing Approval) in any particular jurisdiction other than the U.S.

  • Request for Proposals (RFP means all documents, including those attached or incorporated by reference, used for soliciting proposals.

  • Drawdown Request means a notice substantially in the form set out in Schedule 3 (Drawdown Request).

  • Bid Submission Requirement means a task a Prospective Contractor must complete when submitting a bid response. These requirements will be distinguished by using the term “shall” or “must” in the requirement.

  • Generation Interconnection Request means a request by a Generation Interconnection Customer pursuant to Tariff, Part IV, subpart A, to interconnect a generating unit with the Transmission System or to increase the capacity of a generating unit interconnected with the Transmission System in the PJM Region.

  • UCC Filing Authorization Letter means a letter duly executed by each Loan Party authorizing the Collateral Agent to file appropriate financing statements on Form UCC-1 without the signature of such Loan Party in such office or offices as may be necessary or, in the opinion of the Collateral Agent, desirable to perfect the security interests purported to be created by each Security Agreement and each Mortgage.

  • Federal work authorization program means any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99-603.

  • Perfection Requirement or “Perfection Requirements” shall have the meaning set forth in Section 4(j) of this Agreement.

  • Medicaid Notification of Termination Requirements Any Contractor accessing payments for services under the Global Commitment to Health Waiver and Medicaid programs who terminates their practice will follow the Department of Vermont Health Access, Managed Care Organization enrollee notification requirements.

  • Request for Proposal or “RFP” means all documents, including those attached or incorporated by reference, used for soliciting proposals.

  • Authorization Form means a form specified in s. 440.73.